HomeMy WebLinkAbout0352.093-
~)OI't ___ 2_0_-_2_4
June 17, 1993
THB BOBORABLE CIn COUBCIL
Palo Alto, california
JilUaap 8erf'ice8~J:'e_eDt.s tor :riJ!I_~~.J Year 19'3-.1'!l19'~
Kembers of the council:
:RaportJ.,J:2, Brief
Council action is re~~e~ted to approve the attache4 amendments to
Contracts No, C0006279, COOQ6277, and COQCli14 for services between
tbe City of Palo Alto and the fo.llowing respective agencies:
Adolescent counseling Services r Peninsula Area Information and
Referral services, IcC., and SeDior coordiuating ~ouneil of th6 Palo
Alto Area, rno. Onder tbe amendments, each of t~e contracts will be
renowe4 tor anotber year. In addition, Council action is requested
to approve tbe ettacbe6 short form agreements between the City &n4
the ccmm~nity Association for the Retarde4 i Inc., and between the
City and the P&10 ~lto Unified School District.
_~_ac::tq.round
The K1,llD.an Services Division arrived Itt funding reccmmendations
throuqh the Human services Resource Allocation Pr¢cess (HSRAPl for
tbe bum an services contracts.
A three percent :cst of living adjustment (COLA) wa~ recommended ~or
all bumaD servl.ce agencies that bad a history of a contract
relationship with the HumAn services Division. This percentage
increase "as bas.d on the Ba), Area Consumer Price Index &s of
December 31., 1.992, which was 3.1 percent. This recommend.ation
followed sU~gestion9 from tbe council during aisctlssions held this
past ye~r reqarding the aSRAP~
Furthermore., to alleviate confusion cau~ed by dual fundinq of some
nonprofit agencies t."hrough t~e community Development Block Grant
(CDBG) progr~~ and the City's General FUr.~, Council directed staff
to eliminate joint funding for individua.l agencies. Staff tben
requested aqencies to submit their proposals to the appropriate
f~nd:ing sourc-e~
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catholic Charities, Urb&n Mi~i9try and the Emergency Housing
consortium vere directed to the COBG program. Those directed to tbe
City'" General Fund were Peninsula Area I='.tormation and Referra.l
Service (FAAIRS), Adolescent Counselinq services (formerly Palo Alto
Adolescent Services) and SeniQr coordinating council, witb the
exception ot the senior Home Repair program which still receivEs
$10,000 in COBG fund.9~ {See Exhibit liB" of the Senior Cpordinating
council c:ont:r4ct~l Funding recommen"ations utilizinq CDBG funds
were approved by council on Kay 17, 19934
Bach contraet &mendment and the two agreements include & Scope of
services (Exhibit "A") describing proqram goals and objectives.
Funding levels are reflected in the Contract Budqet (Exhibit "Bn)
tor each agency. Certificates evi~encir,9 qeneral liability
insurance and workers compensation insura.nc~ co;reraqe a.lso are
e.ttached. {Exhibit "C n ). The amendment to the contract with the
Senior Coordinating council inelud!es revised Federal Assurances
(Exbibit tlO"), as required by the C08G pcoqram.
Pro~_~_~ntract Aaendae:ot_~
Adolesoent COunselinq Services,
for provision of counselibg gervic~s
to adolescants.
peninsula Area XnZoraation aDd Referral
Services, for provision of telephone
information and referral services, and
operation of lan~lord/tenaDt and
community mediation services.
Senior Coordinating council, for
provision of services to se~ior adults.
co .. unity Association r~r the Retar4ed,
for provision of serviees to the
developmentally disabled.
Palo Alto Unified Scbool District, for
provision of counseling s~rvices at Gunn
and Palo ~lto High Schools.
CMR:352.'3
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$ 31,338 Gen. FUnds
$ ]52,2.60
10,000
$ 362,260
$ 37,0&Q GeD. Pun4s
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,acawap,datioll
Starf recoamends tbat the city council approve and &~thorjze the
Xayor to exec'ute the &ttachec2 &m.endments to CQntract9 No. C00062:1',
COOO'277, and C0001714 in the amounts of $37,338, $45,320, an4
$362, aDO, respactively to renew tbe c:ontracts for an addi tional
year: Lad the attached Agreements between tbe city and community
ASDociation for the Retar~ed, Inc., and between the City and Palo
Alto unified School District, ic tbe amounts of $26,523 ~nd $37,080,
respectively, tor fiscal year 1"3-1994.
Respectfully submitted,
n.avic1 F .. Martin
Administrator of HumAn services
Pa.ul Thil tqen
0' ector o~mmunitY services
Fleiiing
Manage.!'
Attachments
Aelated CMR8: 1 __ 3:'3, 22):'93
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A.~MEN'!' NO. 4 TO COtITRACT NO. Cu006279
BET'i'i"EEN THE CITY OF PliO .b.-,TO AND
ADOLESCENT COUNSELING SK ·CES
POR COUNSELING SERVI~F.S FOR ~ .ESCENTS
Fiscal YeaJ. .9S3-199
THIS AMENt'HENT to Contract Nc-. Cr.'DOE.279 is r.ldde and
entet:ed ir:.to this --LL_ day of ~~~!--____ , 1993 1 by ar~d between
the CITY OF PALO ~TO. a munie:rp;;.l corporation of California,
hereinafter referred to as ~CITY,· and the ADOLESC2NT COUNSELIN3
SERVICE;S, a nonprofit corporation (Taxpayer Identification Ntl...-nber:
94 -2226071', ",-hose address is 4000 Middlefield p"oad, Palo Alto, CA,
''')03. hereinafter referred to as t!CCRPDRAT1(\N~;
R ____ ~~ITALS:
Wrl£REAS. Contract No. C0006279 was previously entered
into between CITY and CORPORATION tor the: provision of cpr-tain
counsel ing services for younger adolescents in the communi tYi and
~rffiREAS. CORPORATION was formerly kncwn as the Palo Alto
Adolescent Services Corporation and, effective May 15, 1992, became
known as Adolescent Counseling Services; and
WHEREAS, both parties desire to renew said agreeme~t for
an additional o~e-year term and to modify the sections set forth
below;
NOW, THEREFORE, in co~sideration of their mutual
covenant.s. the parties he:.reto agree as fellows:
SE(.'TION 1. The following paragraphs of Contract N::l.
CC006279 are bereby ~~ended to read as fellews, as 0f J~ly 1, 1993:
a. Paragraph 4(&.) .
• {a) Speci fiE:'-.~_Terp",. Tbis agreerr.ent shall co:n:r,<:mce
on July 1r 1993 and terminate on June 30, 199':', unless sooner
terminated as provided herein.~
b. Paragraph 5(bJ.
~ (bl Compengt._.:i,gp. CITY agrees to co:np(':nsate
CORPORATION for the full perforrr~nce of its ser~ices under this
agreement in a total sum r',ot to exceed Thi:rty-seven Thousand Three
Hundred Thirty Eight Do11!irs [$37,338) i!1 General F';;nd mcmies. ~
c. The first. subpacagraph of Paragraph 1&.
"19. NONDISCRIt~INATION. Ko discriro1nation sn311
be made in the employme!:!: of persons under thi s a.greemenl because
of the ag€., race, c C' ... l Or , national o'Ci'3in, an::estry, religion, sex,
disability or sexual pr-e:fe:rence of such person. Si=nilarly, no
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person shall be denied tho: benefits of the Prc"lram, t·r; exclud?d
from the Program, or be subject to ciscLirrination uneer a~y part cf
the P:r-ogram O~ the t1asis of the age, rae!:::, cole:-, natio~al origin,
ancesrry. religion, sex, disability or sexual preference 0': s'cch
persou. If the val\;E-oE this agr.;~ment is, or m2y be, Fiv.:
Thousand Dollars (.$5, DOD) or mo:-e, CORPGR';'.TIm~ agrees to i[eet all
re~~re.'l",,,;n~s ~f t~ ... e pa!o Alto r~'~ln~,C'ipal .,Code pertair:·~.ng to
nonc~scrl.m..l..nat~o~ In emp ... oy![,!2 u t an<J to CQmp-.L.ete 2nd sub",~t the
"Compliance RepiJrt--Nor..discriminatior. Proyjs1or;.s of Clty of pa10
Al to Contracts II on the form furnished by CITY."
d. 1'.he second slJbparagraph of Paragr~p:" 18.
~CaRPO:RATI(1N agrees that each agre"2m~nt fo!" servicEs
trorr. independent pro·.".-iders shall cQntain a provisio:) substantially
as fellows:
Provider shall P!"ovide CORPO?.ATION ... ·i r.h a
certificate statiag tha-t he (or she) is curren::l)' in
compliance ",·ith all federal and State: cf Califor[!ia la' .. ·s
covering nondiscrimination in E-mployment, that he (or
she) will pursue an affirmative CQUI-Se of action as
required by the Affirmative Action Guidelin€s of the. City
of Palo Alto; and tllat he (or she) will not discri::ninate
in the emplo}'-ment of any person under tbis ccntrac"C
because of age; race; color, national origin, ancestry,
sex, religion. disability or sexual prefeL-ence of such
person. "
SECTION 2. Subparagraph 19 (e) is hereby d.:=leted irc:rL
Paragraph 19 of Contract No. C{)O{)62?9 a.s of J·u1...y l~ 1993.
SBCTIO~~. The follo ... ·ing exhibits to Contrac: :No.
CCO(lE279 are hereby a:r.en6.ed as of July 1, 1993 by the ex.l"'dbit-s
attached hBreto and i, ... ::orporated i,~ full by n"'.is rE"fere,"ce:
a. Exhibit "A" entitl~d rl1993.-1.934 Scope of Services".
h. Exhibit "B~ entitled "1993-1934 Contract Budget" ...
c. Exhibit lie ~ enti tIed "Ir.surance Covera9'e~.
SECIYON ___ 1. Exhibit "D" E:ntitle:Q "Federal Assurances~ is
bereby deleted fro],t'. CO:1xract No. CC'OOE"279 3S of Ji..lly 1, 1993.
SECT ... :I: ... ON [;" Except as hc:-orein mOdified, all othf:':
provisions of and amendments to sai.d a9'reement shall re:nain in fu11
force and effect.
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TN WITNESS WrlEP.EOF, t~E parties hereto ha.ve executed this
Amendrne:J.t til€: day and ye3r f irst abCl\-~E: 1Io·r-itteT1.
City Clerk.
APPROVED AS 1'0 FOP .... '"!:
Senior Asst. ·Crt.y· Attorney
APPROVED:
Assistant City Mana9~r
Director of Finance
Dir. of Community Services
Risk Manager
APPROVED AS 'I'D CONTENT:
Human Services A~nistrator
. Attachlne:;.ts :
M.'3..yor
Taxpayer Identification No.:
94-2226D71
EXHIB1T "A":
EXHIBIT ~ B ~ !
EXHIBIT "C":
Scope of Services
Contract Budget
Insuz~nce Coverage
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EXHIBIT ·A"
AlJOL[SCOO COUNSHIN!i SER'ilCES (ACS)
1993-1994 SCOPE OF SERVICES
On CaJIIDUS Couns __ ~J i n9 Pr~9r all
SERV1CES: CORPORATION shall provi<le an {In Campus Ccunselil Program to m.ake
crisis intel"ver,tion and direct counseT'ing services easily ava; 1":"01 e to middle and
high school students and family me~bers. Services sn311 be pro .... ided at Palo Alto
J.ligh School. Gunn High ~chool ~ Jane Lathrop Stanford Middle Sc r.::xl 1 and Jordan
Mi o'dl e Schoo 1 .
GOAL! To prevent and/or decrease the incidence of d~ug and alcohol' use.
suicides. school drop-cut rates~ and symptoms rElated to stress.
OBJECT! VES:
1. Prcv;de 2 licensed~ ~xperienced mental health professionals as prograll'1
dlrectors. and recruit, train and supervise j2 to 14 graduate-level or
post-graduate counseling interns to wor~ at t~e 4 schools in 1993~94~
2~ Pro\dde indi .idua1, group and fami 1,)1 counse1 ir.g to at 1 east 500 students
and family members tnroughout the 1993-94 sc~ool year by conducting 1400
or more individual or family counseling sessions and 250 or more group
counseling sessions. Group sessions shall be co-fac'ilitated by 2 agency
interns. or by an agancy ; ntern and a sc~ool staff member.
3. Pro~ide individual or group crisis 'Work 'With;n the 4 secondary schools.
working closely with scnool gui6anca staff and administrators to respond
to needs on eac~ campus in a timely and appropriate way.
4. The agency program direc.tors shall regularly attend meetings \liith tluman
se'r .... ice staff at a11 4 school sHes in crcier to discuss the needs of
indi .... 'dual students, as well as issues affecting the campus as a whole.
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OrU::_~_I.J_$ ___ frog "'a.a
Des~rJj)llQIl
~~ses
Saiaries
Benefits
Payroll Tax~% and
FICA
Audit and
Professional Servi,es
Rent (B,500 in Idnd)
Phone (1,500 in-kind}
Postage
Consultants and
Staff Development
Travel
Office Supplies
EXHIUT "S"
AlIOlfSCENT CO~SElIHG stRVICES (~.CS)
1993-1994 CONTRACT BUDGET
leta Project Contract Budget
P_r.pJ~_~M~dget ~neral fund:!!
$ 111,161 $ 30.145
4,032 1,310
5,5&0 2,144
172 92
Il,)50 350
1,700 240
375 193
200 200
550 360
'00 420
Pl!~l ications;~ Printing,
Advertising 918 735
Miscellaneous 52 48
TOTAL EXPENSrS: $ 138.172 $ 37.338
TOTAL CONTP~CT BUDGET: $ 37,338
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A4~Olll •. CERTIACAI"': OF INSURANCE
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lNStIl'1I:U EY ALLIED aFa':!:lS
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f 4000 MU:a.F.FIEUl Kl>D
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"CUlt. CERTIRCAl'!!'OF INSURANCE 1:;~\J~ Q:tll!" , ..... ,"x"'~,
trL'N .. ·! ... lI; $ERI/lCES Il\S;]l<'A:lCE
243) N. Euclid Ave~ue
Suite E
I.:<pland ~ C~ 91 i B6
I 90;1-931-3743
C"OOt S:"S-C;OQJ<
ADOLESCf.}.'r COU~SELING SERVICES, INC,
400C MIDDLEFIELD RD. ,.#HF
P~LD ~TO. CA 94303
COVERAGES
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CERTiFlciTeHoCL~DOE.'-----------
DE',PARruEN'T OF HLW.,AN SERVICES
PAUl ALTO
P.'J. £\0.,< I02S(I
Palo Alto~ CA 94.:.-03
Att: Darlene Link
ACO~D ~!i"S (J,'eaj
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AMENDMENT NO. 4 TO CONTRACT NO. C0006211
BETWEEN TIlE CITY OF PALO AL"rO AND
PENINSULA AREA :INP'ORMATIOl~ AND REFERRAL SE~.VICES, INC.
FO~ INPOPXA-rION AND HOUSING S~VIC~S
Fiscal Year 1993·1994
THIS AME~"'DMENT to Contract No. CO G06277 is made and
entered into this day of _________ , 1993 1 by and bet'olieen
the CITY OF PALO ALTO, a muni cipal corporation of California,
hereinafter referr~d to as "CITY,-and the PENINSULA AREA
INFORMATION ANO REFERR.lU. SERVICE'S, INC .• a nonprofit corporation
(Taxpayer Identification NUfl1ber: 51-0192551), whos€' address is
3990 Ventura Court, Palo Alto. CA. 94306, hereinafter referred to
as ·CORPORATION·;
RECJTALS:
WHERRAS. Contra.ct No~ CO::J06277 was previously entered
into between CI"rY and CORPORATION for the provision of information
and r,=-~erra~ se:rvices related to nonprofit and h1J.!t1a.n ee:rvice
agencies as well as housing issues; and
WHBREAS t both parties desire to r~n~w saic agre~~ent for
an additional one-year term and to modify the sections set forth
below;
NOW. UlEREFORE, in consideration of their mutual
cover~ts, the parties hereto agree as follows:
SECTION 1. The following paragraphs of Contract No.
C0006277 are hereby amended to read as follows, as of July 1{ ~993!
a. paragraph 4{a,.
11 (a) ';;E-.; __ ~i fi eo .Tenn. This agreement shall corrtrr'.ence
on J'..lly 1. 1993 and terrninatE:: on Ju:ne 30~ 1994, u::lle.ss sooner
terminated as provided herein."
b. paragraph Sib).
·(b) CampensatiQn~ CIT{ agrees to compensate
CORPORATION for the full perfonnanc,= of its se:cvices under this
agreement in a total sum not to exceed Forty-five 'l'housand Thr-ee
Hundred Twenty Dollars ($45,320) in General Fund monies.
c. The first ~ubparagraph of Pa~agraph la.
I'i~S~ NONDTSCRlr.!I~.~. No discrimination s!lall be
made in the employment of persons under this agreement because of
the a9~, race l color~ national or~gin, ancestry. religion. sex,
disability or sexual preference of s'...lch per-son. Similarly, no
person shall be denied the benefits of the Program, be excluded
from the Program, o-r be subject to discrimination under any part of
the Program on the basis of the age, race, color~ national origin,
1
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ancestry. religion, sex, disability or sEX'.lal preference of such
person, :f the value of this agreement is~ or may be, Five
Thousand Dolla:r;'s ($5,000,\ or more, CC'RPORATIC";N agn;:es to meet all
requ1re~ents of the Palo Alto Municipal Code pertaining to
nondiscrimination in employment and to complete and s\.lb.'TIit the
"Compliance Report--Nondiscrimination PI'ovisions of City of Palo
Alto Contracts W on the form furnished by CITY.~
d. The secoed suvparagraph of Paragraph 18.
lICORPCRATIC'N agrees that each agreement for services
from independent providers shall contain a provision substantially
as follows:
Provider shall provide CORPORATION with a
certificate stating that he (or she) is currently in
compliance with all federal and State of California laws
covering nondiscrimination in employment; that he {or
she} will pursue an affirmative course of action as
required by the Affirmative Act i.on Guidelines of the City
of Palo ~to; and that he (o~ she) will not discri~inale
in the employment of any person under this con.cract
because of age, race, color, naticnal origin; ancestry,
sex, religion, disa_bility or sexual preference of such
person .•
~CTIQN 2. Paragraph 19 (e) is hereby deleted from
Contract No. C0006277 as of July 1, 1993.
SECTION 3. The follo .... ·ing exhibits to Contract No.
CIJ006277 are hereby alnended as of July L 1993 by the exhibits
attached hereto and incorporated in full by this referEnce:
a. Exhibit WA-entitled -1993-1994 Scope of Services~.
b. Exhibit WBI entitled "1993-1994 Contract Budget-.
c. Exhibit "e W entitled "Insurance Coverage"_
SECTION 4. Exhibit ·D~ entitled -Federal Assurances· is
hereby deleted from Contract No. CD006277 as of July 1, 1993.
SECTION ___ ~_. Except as herein mudified, all
provisions of and amendments to said agreement shall remain
force and effect.
2
other
in full
f ,
at
IN
.lune!1dment ttlE:
rnss W1 ~OF ~ the part l.es hereto have executed t.his
.y ~nd y~dr first above vritten .
ATTEST:
City Clerk
APPROVlm AS TO FORM:
Senior Asst. City Attorney
APPROv"'ED:
Assif:ltant City Manager
Di~ector of Finance
Dir. of Community Services
Risk Manager
APPROVED AS TO CONTENT: dll. "f/ -?;:-7~<-____ _
H~an Se=vices AQ~inistrator
Attachments:
CITY OF PAL··!) ~ru.ro
PENINSULA AREA INFO~~T!ON
~TI REFEP~L SERVICES
Its:
Taxpayer Identification No.:
51-0192551
EXHIBIT -All:
EXHIBIT "B"-;
EXHIBIT "e":
Scope of Services
Contract Budget
Insuz'3.nce Coverage
3
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PEHIHSULi
HHI8lT .~.
A !HFORPIATIOH All/) REfERAAl SER'''CE, INC. (PM :RS)
1993-1994 SCOPE OF SERV!C
SER",~ES: COR~ORATlOH shan prO'i102 iT1fo~!llaticn and rehrra1 services for
residents of Palo Aito b,) ma11'1tairdn~ an up-to-date list of nonprofit and human
seY"vic! age-nc;t>sj providing tenant/landlor{'j information and cOlJIIseling; and
assistins residents who nav'2 either renta1 hOL,jsing or nei ghborhood di sputes by
assEssing their needs and ref~rrin9 tn~m to the Palo ~ito Mediation Tas~ Force
when appropriate.
GOAL: To provide a comprehensive clea~1ng~ouse of informatio~ designed to 'in~
resid~~ts with specific resources in order to meet a need. sOlve a problem or
maintain se1f-suffitiency.
OBJECTJV[: Respond ttl 6,500 re-quests for human services 1r;format~on from Palo
Alto reS1dents 3nd area sociai serv~ce ~gencie~.
METlIOOS:
1. Respond to 2.'2.50 caners in response to te1ephone requ~sts f(\1' information
and referral.
2_ Update and maintain current ir:forl!1atlon for over 1,0001 istin!?s in the
PAAIRS rr:3ster f11e.
3. PrQ~ide informat~on to 3,000 ~atrons of the Paio Aito l'b~aY'i~s tnroug~
the PAA1RS Community Resources File.
4. CondLict annuaT review of the PA.ol.tRS master file and the library fIle.
5. Respond to 500 callers requesting informatfun from the Bay Ar~a
lnform2ticn aJiI! Il..e-tdeni Sjl~tt.::. (SA1RS).
6. Respond to 250 caners Ct, PAAlRS A.fter Hours Referral Uf'!e.
7. DistriDute 500 copies of the 1993-94 P~IRS Peninsu1a Area Cirectory t~
area res1dents and organizations.
8. Publish 5 i~;ues of ·PAA1~S Inter-Agency ~ewsletter. distribute to 500
agenciesfindi~idua's and provide 100 copies to t~e Palo Alto libraries.
9. Host 3 roundtable meetings foY' agenc)I directors and staff to discuss
common issues and snarE information about agency acti~ity.
10. Distribute 250 packets of information to n~w residents and employees in
Palo .A.'ltt) tnrougt'J compan~es. oTga:nhations ano ttle PAAIP.S office.
11. Utliize '5-10 VDlunteers to update the agency's referral iistings, maintain
current information O~ the library computer system and assist wit~ other
tasks.
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Page Three
PAAIRS
hhi bit -,4."
11. Distribute informdtion and materials about ~e"tal housi~g issues in both
Engjish and Spanisi'1; including brochures, flyers a!'1d ~ook.mar(s .
12. Send lOQ packets of ~nformation to local rea~ty companies, apartment
managers and neighborhood groups ~c inform tnem of mediation services.
13. Distribute letters to 200 area social Ser'f1Ce agencies. to inform and
encourage staff to refer CliEnts to PAAIRS services and conduct one
informational/training se-ssion for 25 staff persons.
14. PartiCipate in quarterly meetings of the Palo Alto Housing Group.
15. Publicize tMe avaiTablity of sen'lces tho~u9h the media wi,tll public
service announcem~nts, stor:es in local newspapers, and other methods.
EXHIBIT 'S'
PENI"SUlA IHF~RMATIOH AND REFERPAL SER~JC£, INC. (PAAIRS)
!993-199~ CQtr.RACT =ET
Total Organiz3tion Contract Bud9~t
Description Pr9~Budm ~ncr'al_['u_~4~
ExMlJl~_~
Salaries $ 48,160 $ 32,914
genefi ts 2.570 I.2l!
Pa.yroll Taxes 3,558 2,420
Insurance 875 655
Audit 1,000 750
Telephone I, 750 1,313
Postage 1,000 750
Staff Deve10pment 375 28j
Travel 200 ISO
Office Suppl ;es 500 375
Equipment 375 281
Publications 225 159
Misc€llaneous'" 5,400 4,050
TOTAL U PEHSES S 65,988 S 45,320
TOTAL COKTRAt:T lII.lllGET: $ 45,320.00
*Kisceiiant!'ous expense il'lc1\..ld~s printing ($3.700) aa .... ertisir19 ($2.SC), payroll
services ($450). and miscellaneous (Sl,OOO).
: .~
Flinn Gray &. Herterich
3600 W Bayshore. Suite.2oo
PO Bo.lOO,.
Palo Alto, C A 943tJ3
~""="OC"'''C"------------
P~nin.sul.!l Ar~ Information &
RefeTI'l! Service
399Q Ventura Ct., #9
Palo AI.o, CA 94306
IoH'{ ,,"-"TO
~ tlWl><Ul ~os
:!Pf:E,CM.EO ALIl'Ot!
""'" "'''' ~··1IHEiJ AVT{lS
GUUGE ll1I!>LrT'f
""
£VIDE/'I.·CE OF UABILITY INSllRANCE
OF PALO ALTO
HOMAN SERVrCES
1305 N MlDDLLtlELD ROA\'
PALO AI:fO CA 94301
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COMPANIES A.FFORDiNG COVERAGE
Nonprofits' Insurance
I ~1iI1NSD SI"-Q.E
u.wr;------i_ ____________ ~
:1
"! SIiOi.JLD ANY Of' me ABOVE DE"SCR.JBfD PDt-'CIfS E CANCELlE:J &F'OOE T"rlE:
E)(PIF\ATiCoN o .... n: TJ,E"REOf, iHE ISS~ING CQ'APAN"f WILL ENO€:A'o"JK ro
W,ll J_L Dt,yS \liRITTEN NQrlc( 1"':1 THE: CfqT~ICArE 1--I00DE~ ~"',MED TO;-.,f
LEd, EJT HICIJI\E TO 1IAA1~ SJCH N::;,:rICE S",,",U lM?OSE NO C-E,,_lCi",W~;.i'O OR
~l,\,gll_j1,' C\f ),,',( ~IM? UPON THE C'o/"IP',~\n'. rTS "GENTS OR FlPR"'-"E.NTATNi:.S
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STATE P,Q [OX 807. SAN FRANClSCO,CA 9410T-0807
COMPENSATIOH
INS U ~AN CE
FUND CERTlFICATE OF WORKERS' COMPENSATION INSUFiANCE
CITY OF P4LO ALTO
ATTN HUMAN S(RVICES DEPT
250 HAMn. TON
PALO AUC c.t, 94301
P'.:)u::''r NLJ~.t,E.(R
C£RTIFICATE E"Pi~ES
This ;$ to cllftJfy ~t we ~.~ ~5~ued , ... all~ 1"Vo'''er.ii· Compen3011llO'' ms.U'¥l';;~ POi'';;\' '" , f.or,.., .p~;:h'e'l by Ihe
C.alifo.""'011 lr\l;ar,ar,CII! CO<nrT>i~$;ol\O' to tnt emp,orer n..amed bel;:) ...... for tile porie)' pa"od I"d'c.lrd
Tll~s .:ert.ii;;ale of ir1:;ur..,ce is not j01 I!"\!;.uranee poirc\, and dOllS not Imend, e:.:tel"'od or arler tt'1e cc"c'''9'' aHorded
by ti'-e poi'-:If!$ h.sted I-ere'lr"L Notw',(,'ls~d'r1g "1' re-qulfemeot. ter"\ or c?"COihO'1 Of ..... eootract or oth-er doCu:nIl!f"lt
with resprr;:t te ~ich titlS r;:'3rhf.;; .. te of i"SurlnCe m;J)o be ;:osued or m.,' pen.i'''. Ih.e ,"SUfence a~fo,ded by the
policir. dM.Crtbe<l Mte'ln is s.<.ItIjl!r;:1 toO .an l:t1e term:>. l!')(c~usfo'l5 .,d cof1od't'o"~ 01 suc~ :lcl'c'es.-
EMPLOYER'S lrAlILITY LIMli: S3,000,000.00 PER ~ENCE.
PENINSULA AR~A JNFO , AEFERRAL 5VC
3990 VI!!NTURA CT 11'9
PALQ 4LT~ CA g4306
~:-~~;~~{"'!!t---·'---'···
_-~'f; :£
C~-
PEN!"SULI\ APE. INFORMATIO" AND REFERP.AL
S~RVIC€, A NON-PROFIT COR~.
PR!NT'.;O 04-25~S3 F':: 0.':'.9-
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AMENDMENT NO. 5 TO CON11L~CT NO. C000171~
DETWEEN THE CITY OF PALO ALTO Ah~
i:NIOR COORDINATING CCDNC.:i,:I .. OF TEE FALO ALTO AREA... INC.
FOR SENIOR crTIZENS SER~JCES
Fiscal Year lS93-193t
TH.IS AHE?>I""DMEt."T to Cc,~_ let No~ COQ01714 is made and
e ... tered into this da.y of _________ , ~393 ~ by and between
the CITY OF P.AI;C' AL'I'O;--a municipal corporat.ion of Californir:
hereinafter referred to as "CITY.' and the SENIOR COORDINATll'oG
COUNCIL OF PAL{) ALTO, INC., a mmprofit cO!l;loration (Taxpayer
Id~ntification Number: S:4-1~805481. whose address is 430 Bryant
Street~ Palo Alto, CA 54301, hereinafter referred to as:
• CORPORATION" j
R-ECI'I'ALS:
WHER£AS. Contract N~'). C0001714 was previously entered
into between CITY and CORPORATION for the provision of services for
senior citizens in the Palo Alto area; and
WHEREAS, both parties de-sire to renew said agreement for
an additional 0::1e-ys3r t€tm and to modify the sections set forth
below;
NDW~ THEREFORE, in consideration cf tbeir mutual
coven~~ts~ the parties hereto agree as follows:
SECTION l. The folloll.'ing paragraphs of Contract No.
CO001714 are hereby alnended to read as follows. as of July 1, 1993:
a~ Paragraph 4(a) .
• fa) _~'p_~_::'ified T~rrr!. 'This agr::.e.T,ent sball corrtmer,ce
on Ju.ly 1, 1993 and t2Y\':",i.!"~at'=-on .!ur~e 3:', .l994 r unless sooner
ter.minated as provid~d herein.·
.t-. Paragraph 5 (b) .
"(b) s;~sation. CITY agreES to compensate
CORPORATION for the full performance of its services under this
agree...'"Tlent in a total su..rn not to exceed Three Hundred Sixty-t·woo
Thousand Two Hundred Sixty Dollars ($ 3 62,2 60) ~ in accoz.-dance with
the budget set forth in Ex...hibit -B-. Ttds sum inc]udes: Three
Hundred Fifty·two ThoJsand Two Hundred Sixty Dollars ($352,260) in
General Fund monies and Ten Thousand Dollars ($lG. DOO} in COITl!nunity
Development Slack Grant ("CDBS") monies. The CDBG monies shall be
allocated to to ';:,sidize horne l-epair sendces for 10""-inccme. seniors.
Funds col1'1tni ttE:-d under the CDBG program a.re cont ingent upon CITY
receiving the intended appropriation from tr.e federal Department. of
Housing and Urban DE:'vclop:n~llt."
1
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C_ The first subparagraph of Parag:ap~ 15_
"~QJmrSCRIMT.NATiQIj. No discrirninat ion shall be :naae
in the emoloyrr.ent of per-sons under this aqreement;. because ·-:·f the
age, race, eclor, national origin, an,:r::s try , religion, S2X,
disabilit}t or sex--.Jal preference of sl.:cn perso.'1_ Sirrd larly I no
person sha.ll be de:r..ied the be~efits -of the Pr-ograI:'., be excluded
fr0~ the Program, or be subject to discrimination u~der any part of
the Program on the basis of the age, race, c8!cr l national crigir~,
ancestry, reI igior.. , sex, disability or seX"clal preferer:.ce of such
person. !f the value of this agree_'T:er.t is, or may be, Five
'l'housand Dollars (.$5,OOO) ·~r more, COR?O?..ATTO~ agrees to meet all
requirements cf the Palo Alto !·~un:i.cipal Cede pertaining to
nondiacrimination j r. employment and to complete and submi t ~he
"Compliance Report --Nondiscrimination Provisions of City of palo
Alto Contracts~ on the form furnished by CITY.ft
d _ The second subparagraph of Paragraph ~B.
~CORPORA!ION agrees that each agreement for services
tretr_ independent providers shall contain a prevision substantially
as follo\lls:
Provider shall provide CORPORATION with a
certificate stating that r.e (or she; is currently in
complia::1ce ..,..-ith all federal and State of California laws
ccvering nondiscrimination in err:ployrnenti that he (or
sh~J will pursue an affirmative course of action as
required by the Affirmative Action Guidelines of the City
vf Palo Alto; and that he (or she) ..,,-ill not discriminate
in the employment of any person under this contract
because of age, race; color, natiDnal arigin~ ancestryl
sex, religion, disability or serJal preferenCE of sucr.
person_ 'iI
SECT~ __ QN '4. T"'~ [0110w1:19' Exhibits to Co::tract l~o_ COJG17::'4
are hereby amen,je,j as of July 1, 1993 by the exhibits attachsd
hereto ;::l.:1d inco!:":,:.'orated in full by U-;is referen':E:
a. Exhibit "A' el1titleo. "1993-199-4-Scope of ServicES" .
b. Exhibit "B" enti tIe,j "1993-1994 Contract Budget" .
c. E.x.hibi t 'C' entitled II'Insurance Coverage" _
d_ Exhibit 'D' entitled " F€deral AssuranCES 11_
SRC'i'J_QN_...d_ Exc-::pt as herein modi f ied, all othE:r
provisions cf and am,endments to said agreement shall remain in f1...ill
force and effect.
2
9lC6C I hd)1'1'206S r
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. Amendrne.'""Jt tho::
:E5S WHEREOF. the part:i,=s he:.-eto have eXecut
:i a,"<j year first above ..... ritt,;;-I'J. .
ATTEST:
City Clerk
APPROVED AS TO FORM.:
Senio;r JLss t. City Attorney
APPROVED:
Assist~nt City Manager
Director of F£na~n~c~ec------
Director of Planning and
Community Environment
Risk Manager
AP?ROVE~ .AS TO CONTENT:
Attachments:
CITY OF PALO ALTO
I-layor
SENIOR COORDINATING COUNCIL
OF THE PALO ALTO ~~.EA, INC.
Taxpayer rden~ification No.:
94-148058
EXHIBIT "A'":
EXHIBIT PB":
EXH.IBIT lIe ll :
EXHIEIT ~DII':
scope of Services
Contract Budget
Insurance Coverage
Federal Assurances
3
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HHIBlT "A"
S~IOR COORDl~'TI~6 COUNCIL Of THE PALO ALTO AREA. INC.
1993-1994 SCOPE O' SER~rC[S
SER:V[CfS: The Senior Cooroinating (oune;'l (St.C) sl'1all plan and impTePlent
programs tc meet the unmet n~eds of seniors in the Palo Alto area.
sec shall handle the admin~strativoe functions of its various programs. develop
fundraising mi!thods and implemen~ shoTt and :ong-term goals through this
strategic planning e'~ment.
sec is a:1 umbrella oTgar11zation which shall prJvide senices throug~ the
fo11owing five majo~ programs:
Senior center of Palo Alto
Senior Day Health Program
S~nior Home Repair Service
Retired Senior Volunteer Program (,qSIJP)
Home Equity loan Program for Seniors {HELP)
GOAL: To pr-o.ide lead~rship. planning. coordination and services in order to
p:"'cmote and enhance the hea1th, independence and we11-oeing of seniors in the
Palo Alto area.
PROGRAM OBJECTIVES:
L Maintain financial sl,;pport from the cOJTlTlunity to at least $336,500 (a
higher target will be established in June 9 1993, when results of the
current yroar's campaign are known); cO!1tinu€ impl~mei1tatio!1 for the
pTanned" giving camp~ign to ins~re long-term fi!'1ancial stabilit"..; and begin
the process of br{laden~ng tile ~· ... ;1cr base.
2. Continue implementation of operating plans based 0:1 the strategic plan
a.dop.ted in June. )991.
3. Continue the agency-wide intensive use of 300+ volunte€rs to prov~~e more
than 13,000 hours of direct services to seniors, and caregivers. as well
as support services to program staff.
PROGRAM OBJECTIVES:
1. Provide consultations to caregivers 1r1 nef:d of practical advice~ link:age
to cOnlTlunity resources and" emotional support. (65 consu1tat10ns)
2. Provi~e emot'onal support to caregivers in a twice-m~~lthTy group sett1ng
facilitated by social worle. staff. (175 attendees)
'-..... '''!'r..... ,-.. --, -.,.,--,' -.--1'
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Page Three see
Exhibit -A-
PR06~ OBJECTIVES,
1. Enroll less independent oTder adUlts in a structured pro9ra~ tailo~ed to
indivi~ual needs. (3,400 Palo Alto resident days)
2. Providi:' lower i'r.come Palo Alto 'ess inclepencent elderly witt1 access to tl'1e
Program. (2,000 Pa'o Alto resident subsidized days)
3~ Develop and maintain an individualized six~montn treatment pTan far each
participant which sets goals for maintaining and/or improving funct;o~a1
';'Ipubilities in the activities of daily living. (110 participants
.. Iro1 :ed)
4. Counsel and refer approximately 300 families who do not (imediately)
utilize the program.
Senior Home Repair ~JrYic~ (Funded with CDBS Nonies and General Fund)
GOALS AND OBJECTIVES:
1. To provide l:)w ccst home repairs to PaTo '.He and Stanford homeowners nat
previously served. (120 J1.C:W homes)
2. Complete repairs, painting. and insta1Tstion of safety/security de~ices.
(500 jobs compl€ted)
3. Provide subsid'zsd low rate~ for low or very low jncome senlor homeowners.
(200 jobs subsidized)
EJ:HI8IT "B"
COORDINATING COIINCll
.994 COfITRACT BliOOET
"',----.,
Description
~_~J~_~
Total Organization
Project~_~'~
Contract Budgel
CDBG nm_(t~
Contract Budget
~i!LFun~_~
salaries
Bi!n<t:fi ts
Payr,,11 Ta.xes
Insurance
Audit
Rent (in-kind)
Utllities
Phone
Postage
flJnd'rais;r.g
,Travel
Office Supplies
$ 897.624
95.88~
67.584
55.~05
8.775
446.502
18.700
14.950
7.315
34. 1~2
1.800
14.007
1.550
Ma1ntenance. Repair 70,750
Di rect Servi coes 207.527
pub'ications 29.539
Miscellaneous 8.955
TOTAL EXPEWSES $2.002.631
*Home Repair Subsidies
$ 10.000
$ 255.595
25.343
19.561
J9 .481
3,300
2,500
4'00
1.500
la,2~0
5,290
$ 352,260
TOTAL CIlHTRACT BUDGET: $ 362.260_00
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Flinn (;ral & Hatertch
36()O W U:l}"'.hore, Suite .200
P 0 D(l .... 10D36
P2lQ Attn, CA. 94J03
Senior CoordinatIng Council
450 BrJlint Sued
PaTo AllO, CA 94301
w:lt1"'~ ~ ~QMPUI!;;A T1~
MoD
tMr>(;"':SIS" lU!lIU"n
cn·.£..<I
I FollIl't\;""'1
PAC279912101
CAP242932402
lJMB IJ8i96S02
WCOOlS86.31Q
PAC2799121()2
COMPAN1ES AFFORDlNG COVERAGE.
C7iQU92
01/0 lin
07/01J92
OijOl/92
Great Am~.ric~n TI1.~llranCe
General Acddent
{jiiC\U93
0'7101'93
{l:i/Oi/9J
RCtJ", ... ~.I'..:~'
I ~ar"-:;d""'J
$100,000 lim:l
$501} I}.rd..
t,
1,000,0('0
'-5.l:.JU;:-~-J':>N nus
C£:rlint"::llt hfllder is named 3S an !l.ddilional iI1Sured (GetH'r.d Liab:lity) •
Ci:)' or f'i.:11 Allo
At1n: l'lJ.~·d~::l.slng Dept.
P.O. 110'\. F,250
p,";,) A rL',.f.'A 9:jJ03
-
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I I SHOULD A.NY or 1}1E ABavE DE.$GI1IBED POI.":IES BE" C.l.I<CflL;:':, C,~C::::: TfCE I
'" E;(f'I"AT~ O»TE: THf;.Rt-QF, THE ISSUJ~Ki COMP,vN W'LL ~lS'!\..U::;;: ~ \I,~ll. dL DAYS "'''!Tl7:\, Mr,'ileE TO Ti-\l: CfF<:I:;I;::Ii,T:: l-'n,on-lJ.'}cJ TO T;,:: I
• : LEn, 1;.L.'t,'ln:,"(.'ClP:iIt~:<"~"",,",'3:;)''''.~~''':':I!!~S~'O.:t:~S5''''JCCO:):.l;-X''::''''tlC~\~~.
f ~_":::~!k:\""~'l(~\l'U.o.)..~~'\"'.A~~"~CS'~~'."iJlJW.i.n."':;':~ J,
J : AUT2'"!UIJ 1IC;;O~ES.Ei'lT .. ArnE.......... .. . \.. . '. . .. I l r'" I~JfLI _>~ ___ . ____ _
========:1 r "'::"" J<;ACO"RD C93pcf,,,,Tim, 1';% I
..
-
A.
1993-199~ FEDERAL ASSURANCES
BY RECIPffiNi ("GRANTEE") OF
FEDERAL COMMUNITY DEVELOPMBH BLOCK GR.AJ>..i (CDBG") FUNDS
GRANTEE hereby assures. and certifi~ that;
(I) It fKtS5esse5 legal authority to receive f~er.tI gmrlt funds and to C'all)' out the pro-
p0sed program(s)'assisterl thereby.
(2) Its governing body has duly acquainted it.~1f with the funds application, including: all
understandings and assurances contained then-in. and directed and authorized the
person identified as the official representative of GRANTEE to pn.1\,:ide such addition
al information as may be reql..,dred hereunder.
(3) It consents to ac<:epI the jurisdiction of the federal or California coul15 for the purpo;e
of enforcement of !t5 responsibilities imposed hereunder.
(4) The I'!QPOsa:! prograrn(s) has been developed so as to give maximum f""sible priority
to activities which will benefit krw ana moderate income persons..
(5) The receipt of any program inoome, as defined in 24 CFR 570.5OO(a). as amended,
generated b}' tbe use of grant funds under this Agreement, ~rill be ~orded, reported
and returned to the City of Palo Alto ("GRANTOR") in accordance with 24 CFR
570504" as amended.
(6) It will comply with the prov;sions set fonh in 24 CFR 85.43 and 24 CFR g5.~
regarding the suspension or tennir.atioD of a grant agreement for cau~e nf con .... e
nience.
(T) It will maintain and retain all books, documents, papers. fmancial, or other recC'rds
which are pertinent to L.le grant for a period of not less than three (J) yars follo\\>'in,g
tbe expirn.tloD of this Agreement. GRA~I.'"EE will anow GRANTOR and the U.S.
Department of Housing and Urban Development, through any authorized repn::.:;enta
tivcs, access t(1 such documents, papers and :reo:ords.
(8) If GRANTEE is a primarily religious entity, in connection with the provision of
servke~ required under this Agreement, GRANTEE agrees to comply with federal
regulations specified in 24 CFR 570.2000). GRANTEE ful1her:
(a) will not discriminate against any employee or applicant for employment on the
basis of religion and will not limit employment or give preference in employ
ment to persons on the basis of religion;
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(b) will not dis.crim:.r.ate aga.:.ns.t any person '3pply',ng. for s~("h scnil(;\;s O~ the basis
of religion and will noC limit such services or gi.'e preference 10 persGn.~ on the
basis cf religion;
(c) ~m provide no reljgiOtls instruction or coun~ling. COfl1jl.lL:t no reli~iou.3
wurship or .services, engage in no religious proselytiling. and exert no other
rdlgioLls in..fluence in the provision of such 1eTyi,:es; and
(d) 'ii,1i11 ensure that the portiO!) of GRA...·,~TEE·5 facility used to provide the
.services s ... .aIl cC'lItain no religious symbols Qr decorations, other than those
pennanently affiXed to or are part of rhe s.rnlcture.
B. GRANTEE also hereby assure.s that it shall:
(1) Comply with the nondiscriminatioc provisions of publk law 88·352 (True VI of the
Civil Rights Act of 1964), and the fair heusing pro\lision:> of public !a~r 9{l-284 (Tjtlc
vm of the Civil Rights Act of 1968) and Executive Order 11063, as amended by
Executive Order 12259, with respect to saJe, lease or transfer of Ial1d acquired,
clea.red or improved with grant assistance,
(2) Comply "'ith the provisions of Section 109 of Title I of the Housing and Community
Development Act of 1974 whicb prohibit discrimination.
(3) Comply with the Fair Housing Act of 1989 (42 USC 36iJ120). which pro!ubils
discriminatory housing practices based on race) color, re1igion, sex, national origin.
disability or familial status.
(4) Comply 'Pith the Davis--Bacon Act, as amended, Federal Labor Standards pro'.risions
with respect La all construction contracts in ex.cess elf Tq,,'o Th0usand DoIla.Th ($2 ,OCJO)
(5) Comply with Ll;e requirement of the Fl<x>d Disaster Protection Act of 1973 and the
National Flood Insurance Aci. of 1968 applicable to 3cquisilion or construction
projects.
(6) Comply with the relocation and tfispiacemenl requirements of the Unlf01ln Relocation
Assi'illm ce and Real Property Acquisition Policies Act l~f 15:170, a. .. amended
(7) Comply with provisions. of Execlltiv~ Order 11246, i.'i amended by Executive Orders
11375 and 12086, on equal employment oppommitie:s and affirmative action relative
to employees and applicants Olr.d' nonexempt contracts and subcontracts,
(8) Comply with 42 USC 48JI(b), and 24 CFR j70.6iJ8 and 24 CFR Part Jj of the HUD
regulations, prohibiting the use of lead·based paim in the constructiOl"J or rehabilitation
of residentiaJ structures.
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(9) ~ provision'" ("If 24 CFR P'.irt 24 which prohibit the lltilizatior, of
nded, or i' ;ble contracl0fS or suhre::ipients.
(10) Comply lItuh the unifonTl :]istr2ll\'e re,quirements and cost principals of 24 CFR
Part 85 ""0 Ol>ffi circular, A-S?, All 0, A-l22 , and A-12S and A-133 as they relate
to the acceptance and use of federal funds by nonprofit organizatiom:, and a", other
wise may be re<}uired under 24 CFR 570.502, as amend,c'J.
(U) Comply with the requirements of 24 CFR 85.36 and Ot\1B circular A-110 with
respect; to conflict of interest, and as. otherwise may be required under 24 CFR
570.611, as amended.
(12) Comply with theJ'Irovisions of the Hat..:h Act which prohibit the use of federaJ funds
(or lobbying activities.
(13) Comply with Section 319 of public law IOH2l, which generally p!1Ohibits recipients
of federal contracts, grants or loam. from USlUg appropriated funds for lobbymg the
e~ecutive or the legislati~ branches of the federal government in connection with a
specific contract, grant or loan. Accordingly. GRANTEE. hereby certifies to the best
of its knowledge and belief, that:
(a) No federal awrupruued fund, have been paid or will be paid, by or on behalf
of GRANTEE, to any person for influencing or attempting 10 influence an
offICer or employee of any agency, a Member of Congress, an offKer or
employee of Congress, or an employee of a Memocr of Congress in connec
tion with the awa.n1ing of any federal contract, the making of iUly federal
grant, tl-.e making of any federallcan, the entering into of any cooperative
agreement, or the extension, continuation, renewal, amendment, or modifica
tioo of any federal contract, gr(lnt, loan, or cooper:n.ive .agreement; and
(b) 1f any funds. ',)ther than feder:<1 appropriated funds have been pajd or wiD be
paid to any person for influencing or anempting to influence an officer or
employee of any agency, a r-..fember of Congress, arl officer 0[" employee of
Congress, or an employee of a Member of Congress in connection 'I,vith this
federal COI)Crrtct, grant, loan or coope."'3tive agreement, GRANTEE shall
complete and submit Standard Fonn-LLL, "Disclosure Form to Report Lobby
ing" in accordance with its ins.tructions.
(14) Comply with the Age Discrimination A~·t of 197:5, as amended, which state:. that no
persons in tile United States shalJ, on the basis of age, be de"ied the benefits of, or be
subjected to discrimination under, any progrdIn or acti .... ity recei .... ing federal fmancial
assistance.
(15) Comply with Section 504 of the RehabiHtation Act of 1973, which prohibits dis.crimi
nation against J>OOJ.lle w~th disabilities in any federa!ly assis.ted progrdm.
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(16) Comply ioo'lth t~e Americans ~'ith DiSlbdilies Act of 1990, as amended, and imple
menting regulations when published.
(17) Tran'Sfer 10 GRANTOR any CDBG funds on hand, ana ii!1y aC'".counts receivable
attributable 1.0 tile use of CDBG f~.md:;., at the time of !!":-. .. piration of this Agreer.1ent.
In addition; GRA."ITEE shall ensure that any real property under GRANTEE',
C0n~rol that ~'as acquired or improved in whole or in pan wi~h CDBG funds in exce'5's
of $25,000 is either:
Ca) used 10 meet one of the national objectives in 24 eFR 570.208 until five yean;
after expiration of this Agreement, or for such longer period of time as
determined appropriate hereunder by G.RA1'i'TOR; or
(b) is disposed of in a manner whit;h results in GR>\NTOR being reimbursed in
the amount of the then currem fair market value of tile property less any
portion thereof attn"butable to expenditures of DDn-CDBG funds for acquisition
of, or improvement to, the property.
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AGREEMENT
SI' "'NO ElE~EN f.;E CITY or PALO AL TO :"'E:"'E:'j""-T~P '1::r (R;:;[C.' ~,) ~,S (rTf AN:
(NAioIEi 111 Cornmur.J..1x......A~_Q.ci.Q1JQ.!J. ___ f9f"' nL~ _____ E.:.:_:~_L.d_e-.ct -::
I ~DOqE:s-SI 5] 5 E. C f!..£_rj~Q_IJ __ J~J:l_~_d-_ ___ : '7 -!, __ .-p_Q to_ nAL1Q
• CONTRACTOR SHALL PRQ',!:Cll Ofl r JR'i':;:'" i"~~ __ :J' .:W'M:; ::;~-t:Uf If~ SER'.'I'::[:'; ", .. D'CR 1.~",Tf"R'AL5 SPE-~I' 'l'::' ':-' l;':"IB : __ "_,::\
.. -;-r"'CI'lEQHE:.8£!OAN~INCap.f'OFlAr<:r,."'EflE:N9" i";'SR~:~'<i',..:: inciur1!:19 the provision of .:;;.ervic€s to th(
developmentally disabled and t~cir fi!n;il :<;"5 tc '::5:5 1St in the prc.r:css of personal devefop
ment, family compatab:li:y, and community j;"tegratton. Guarteiiy reports shal! be
submitted by Contractor to Cjt)' c;s described in Exhibit "A" for thE periods endin9
Sept€mber 30, 1993, Dec~mber 31,19'13. March _I. '994 and Jure 30, j99'1, .... ithir-.
fifteen t15) da)ls following e~ch quarter.
• EXHIBITS THE rOLlOW!NG olin-ACHED £~rllal~.s -kR~B~ ,U-lr lIoIi!::lO' p,~'pT ~r TI-'IS A'JI";EEMENT
UA II ~xhibit 'IA'I:
Exhibit IJ!3U;
Scope of SE-n'ices
Contract Budget
Exhibit I'C\~: Certificates of Insurance
• TERMS THE SERVICES A."D~ MATERi,l,L '!:: "'L)>1",,:O"-c":) :.:~: C:"-~ :''-1 IS AGREt:'AENT SkA~l CQl,1~<:IIit.i: 01\ _-----' __ """! 1;;,-,~_lL9..9_3.
MO SHA"-l8E COlA~Lm D 8EFOI'« ...-:l... LJ_!l.~ __ lQJ __ ...li~ __ ~ _______ ,_
• COMPENSA nON FOI' ~E FULL Pf RF'ORI,'A,'<':;:E cf rhlS AG~fE:)."fW
~ Cm'$HJ\t.LPA.'tCQNTRACT(.)R ?aymems shal! be made within fifteen (15) daiS of receip~ of
approved quarterly invoices for admi;"oist.r<'Jtil/e costs, subject o ~C;TOi<-S."'~lP"~·(.trv to City review and iJudit. Tota! payment Sh'11l net exceed $26,523
far th-e term specified above.
• PAYMENT RECORD (DIOP)'I'1Th1E"-" LIse ~E'''E.RSE S·DEI
• CITY ACCOUNT NUMBER: KEYCOO£ -OOJ~CT I PPCJE'';T ----P'1113.E N"2 ...,.........~'.t:,U·.T------o02~nI:D46----+=~= ____ -___ -=j.25 ,52Y -----=-1
• GENERAL TERMS AND CONDITJONS ARE rNClUDELJ ON SOTH SIDES ()l'" THJS DOCUMEiVT
THIS AGR[FMi:J/T SHALL ~ECOME EFFE-CTIV: UPON ;r:; A·1"R::),':'~L AND EXE~IJTlON E~' CITY. IN ',/1'1;111::55 iHt"'EOF, T~E F'ARTlf:S '1A~E Ex:[.uTEO HilS
AG.fI,EEME~nj{E CA'I. MO~H.Ai\:D 'lEAP, FJ?Sf WRrITErw "S'J'.IE:.
HOLD KAIIMU'S$. CDN rRACTO," a(jr~ Ie> in,j.eor;-,n'» CE1, ",d ~~:l ~'Jlr: ~Mm;~!iS CI rv, ~5 ()~'cers, ly~;-Is, ii:::J E~;IC.,~c~ ~"D("-an)' a" d a~ d~ ,r;a~~s clo; 1", -n' lob-t.tj ::rl
!nr ~ure. ir,Ci:.ldinll "'.r:?n~I'JI1 .. .ath, c~us.r:J.o) or .;i,i"~ C'j~ C"! :U-~:"'Acr(j::: S, it:; ~the',,' ~g~n~s 0: ~:r;.'I:,:.,'c~, ~"~ql'~' 3C~~ e '-~';;, cr J;-iss'o-" Q~ '/< :-' ,
r:1i!\oC()n.-lu~. 1]" .:-;,rr;~,", lei \\I'w;:11 (h2 law ,(I1ilC';l.:S S:,'I.:t .I~·" ::i ~~ : :1"-?4CT(}~ Ir t:'~ 08:1'0 """'.ar:, Jr 'a: i.'~·~ O~.-of~-;-; :---:, .' •. "~ -~n~ ~" G:J 'iT"ACFJ f<~
EHTlRE AClREEMi:JIi. Th:! ~reem·:·.1 u" rh~ tD'r:-:~..ill.a ..... .:;,(:i;,-,~_~U:tJ'_;ill_'S.~nbe.~j;~ re~rt~c~: -:'"'e ~r:, "" iiQ I~e'-':~ '~ tJ~~.>'''~ :"'e pa~,t~ II' th "f.~~'~:t ~(I :.~ ,'"' ~f'o~e
~'lU !>.lie l'1lt1t equl.p~~nt, mal'!'r."s "r SU.p~1·8~ c:r OlJ:,:r,.nr 1:-r se:"'G~S wnlcn ~ay ~~ tl'e 5~t::t'ct u~ ~I~ ::~~trJ':: II!' p"1:( ~~'~f'T1f-:S i'!!~·E~~,"t.:,~;,., !~a.1~m9~ls
nN(jljatl"ns iHld ·_n1tr:~~i rq!i ... he:~it' rllill ,x 'IIir;'1en are S~;'fr;~G e: ~e:~h')
• PROJECT MANAGER ANO RrPRFSENH,ll'.'<:: FD" ::ITY
~J.~E _nJJallid F .... '0a,..tin~_.dm.i_pJ.~J_t~JQr:.........._
Human Services I
DWT, __ ..J&mml,.1.rd_ty Servic:e_~ _____ __
p ,0_ BOX 1 0::.>50
PAlD ALTO. CA '143:JJ
TelflPhOn.e .....J.1_S...:.2...D_~ __
.. tNVO,CING SEr,c AU. INVGICES 7(. THE CIT'! ~,-:TI, ",,",:).E.CT ·.i .. n ...... CEI"
• CfTY OF PALO ALTO APPROVALS: ",R(lI_,"E ~'-='P Si:3.N"'i";J",E">A~CQi~l\ING T(lN-lME'):_"S 'r, ~P""R':'.l1. S.OtE.5 8.EU .... ,
fr~.T"r'!jr~IIRl'UHc .... or~H~" f113KMM.AI;rR-----
-Rud')':'ltd I
[J ___ _ __ __, _____ _
IF' OVe:R'S ooc RE.QUI~(S cln M,I.N_Ao..'i __ Fr s s (;.r-.A.T [,E I I "n olf",,,ero -----n-r-
L===:-,,,·~_~,___l:-=_-=-~."_~_c~_~~-,--_-:::: __
------,
:~,"~,~G' ,:tJr.{;·"'~n ~J"';', S~;;,::'T!':If,f
-----J !~ 0 ~'[1 ~~ 'J ,~ REcQl.Jl ~ES 1.1>'·"0>1 A', J CI 'i" TTOR"'E'Y SiGNA TUf<:E S \
~ msr Af'f'~C\"l1.D A.S f~f'0ir.;-~_~ ,n.,.c.,.c,-=J ____ .... nn __ _
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EXllIBIl "A"
tOllUlIl'f ASSOC\~TlOli fOIl TIlE RfTAAl''1l, INC. ( ~)
1993-\994 SCOPE OF SER~
,.-"¥>"
SERVICES: CA~ shall provide corrrnunity-based s-ervices to dev-elopll1enta11y disab1ed
individuals and their families to assist ;~ the process of personal de~elQpment,
famiTy compatabtiity. and cOITIllunity integration. Additionaliy. CAR shal1
inltiate and/or part:cipate in communIty awareness. prevention~ and advocacy
services.
C~r"'It.LEd~at.;(m Prograa
6O~LS; To encourage cOITITlunity nnr~ness and acceptance of persons with devel
oplM'nti!l disG:b~ 1 ities~ To proV'lde infoma.tion on the causes and the preventron
of menta1 retardation ~nc: other de .... e1oprnenh' disabilities. To address tr,e
inequities: of treatment or opportunities for persol']s with d~velopmental
disaci1)ties and seeK cOrr'l!ct1on thro~g~ advocacy~
D9JEClIYES,
1. Provide a m1nlmum of 1500 persons with education and training related to
prevention ancf/op" c~unity service neecs of peop1e with delielopmentaT
disabilities.
2". Provide a miniml.RJl of 500 elementary school aged children ",ith information
about dev~1opmental disabilities.
3. Maintain coordination of t~e National Safe Kids toa11tion of Santa Clara
County focusing on prevention of unint!-r.tfonal ~njury to children from
"rttl to 'g" 14,
4~ Make avaiiabie a min'mum of 15 infant and toddler ca~ seats to families in
need~ especially lo~ ;nc~~ familie$.
5. Maintain awareness of princ;p:e ~egislation and regulatior,s on the Federal
and State level and to serve as a consl!itant/resource on le-g1slati'ole
issues to consumers. par~nts, and/or or9anizations, on an as-needed basis_
6. Continue to ser~e as a co~ittee memo!r on the Disability Awaren~ss Task
Fcrce of PaT a Alto.
GOALS: To provide an aquatic environment for indi~iduals to promote gross motor
SKill deve1opllll:mtr remediate physical det(!rloration, develop impulse control,
d4!val¢p attent'ion to in~trlJction, and deve10p water s.a.fety sk'il1s; to prollid.e. an
aquatic el"!vi ronment for adu1ts whose physici ans have reccnrnended hydrotherapy or
s'WilTlTl1ng for treatment of an acuh or c~.ionic di sabl1 it)'; to provide opportunity
for successful ~xperiences. for indi ~idua' 5 in order to enhance their sel f-esteem.
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Page Two
CAR
Exhibit -.A-
OBJECT! VES:
L Pro ..... idt-therapeutic sw;;rrr..ing ar.:d instruction to a minimum of 950 adults
ar.nually.
2.. Provide i!I minim10lm of 30,000 hours of therapeutic s'Wi;w and instruction
ann.u;:s11y.
3. Providoe-pupil swim and instruct~.on to a minimum of 250 cht1dren and adults
annually.
4. Provide a mint~m of 6.000 hours of pupil swim and instruction annually.
5. Provide tralnin9 to 125 in~lviduals i~ the commuhity which ~ould qualify
them to teach !wimming to individuals with developmental disabilities in
the pupil swim program •
.s. Provide short-tt-rTn or ongoing consl!.1tatlon to a minimum of ten
organizations concernin9 aqu~tic pro9ramming for ind;vi~uals with
disabi 1 ities.
QUARTERLY REPORTS: Contractor shall provide qJolarterly act1vay reports relating
to this Scope of Services for the periods ending se.ptemlH!-r 30. 1993. December 31,
1993, Narch 31, 1994. and June 30, 1994, within fifteen days after these ~ates.
Each report shall cover tne preceding qU?lrter. and' other such infonr.at1on as the
Project "anage~ may r~uest. The-final report shall focus on the Itreceding
quarter, but also shall provide information on contract services for the entire
year. fach report shall be prepared' in the form agreed upon by the Project
Manager and' the Contractor.
AIIERlCANS VI11l DISAJlILlTlES ACT: Contractor shall comply with the Americans with
Ois,bilities Act [ADA) of 1990.
l)escription
Salaries
BEnefi ts
Payrol1 Taxes
Insurance
Utilities
Phone
Postai e
Consultants and
Staff Devolopment
Travel
Office Suppiies
Equipment
Maintenance and
Repa ir
Mi see 11 a,neous
TOTAL EXPENSES:
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CO!9UIITY USOCIATlOll fOR ~E tETAAlIED (CAR}
1993-1994 COMYRACT BUDGET
Total Project
!!.J:Qpos~ Budget
$269,298
32,615
20,601
10,826
34,495
3,514
3,991
5,38D
650
6,146
2,480
2,5S0
24,130
$416,676
Contract Bud!l"t
J;<!M:ral Funds
$ 22,523
3,000
1,000
$26,523
TOTAL COMYRACT BUDGET: $26,523
X
NATIONAl crrmmo, I~C
13~'5 GTtI81'I~, Sulb '2. 50
P.~, 8:)); 189
WllIW, CA <106(I6
COMMUNJTY ASSOCIATION FOR
THE RfTARDEC, INC.
525 E. CKARLESTON RCAD
PALO ALTO, CA. 94306
TMot......a:
~'ICW IVIi£IW. LI.UlUTY
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tm' Of PM.O A.LTO \$ NAMED I\S M)nrnCML INSUREO
CITY OF PALO ALTO
HUMAN SE.RVICES
P.O, BOX 10250
PALO ALTO, CA. 94303
---------------
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AGREEMENT
BY THiS AGREEMENT MADE "i~O ENTE.REDINTOC'!'IJ :1-'( __
fry "'''[.l ~ETWHN jHc CITY OF PALO ALTO Il"E"EIN,O,clEI:, A:i:FE'":-;!::,~:) .... 3 CiTY """':'
[NAi.I£i~' I __ ."£2.1 0, .AJ l.Q ___ J,LG.Lri_~2-Sc r' ogL.hl.ii..1TL',:.J.__ ___ ',2: _ __. ___ . __
IA.DOR(SSJ _2j_~ftitl.rchi\' ~~.f~~_~_ __ ICIT"; ~~ __ ~l!0
j>l'E"'C.JNAFi iiR RtJ!' RRE L1 ro,l,S CONTRAC T OR) 'I',; -::()NS 10 r: RA' iON 'JF Tro-E.; R '¥i'..IT'J ..... ('G\I.::~;,:.r. ,5 rr:f ;>.1,"',1 I~S HE '1~ 1"(, A3 prE A5 F 0<.1 CW.S
• CONTRACTOR stiML 1'>R"'8VIDf C~ ~UR~jI.Sf" "rr rOLL::J ..... :~;G SPECII',t":o ::'EFi:','CO:S MI.J<J~ M"'T'=RI,~LS S<'(C" IEJ I'; E,XHI~17 ,~6 'I _
ArlACfJ[O ~"tET::l.M<D I~.CORPC'RATED Hl~f~ el" ~roIIS RC"FERE--.CE inc I ud J r'1g m', t,h i ng f u ,"lds 9 r en ted u ndei' "s
agreEment to prDvid<: two ell futi-time community cour1selr 'C. (one 2t Cl.lnn High Schcot
and one at Palo A~tD High Schoo:) who shirll address predictablt: issues in adoresce!'1ce on f"
a regular, fu!i-Hme basis -and in(;reas'';.' ~,tud(·r\t aCces.s to persc:loi cC"Jr1seiing services. ,
Reports shall be submitted by Ccntr.actor to Cit)" as described in Exr.fbH: ':A u fo(" the
periods eliding November 30, 19n. February n. 19S1t and June 30, 'l99~. witllir; fifteer'J
.. EXHrSITS THE FOU.OW:NG A fl "eKED f.xHIB,1S HE Ri::e';' ,"'R:; ~''''r'E F,oIR";" C'" T""IS Ar:',FlfOl:"'E:~T' (15) da ys a ftcr each pe riod,
Exhibit liN': Scope of Suvices Exhit.>it I' c: II : Certffi..::..:..te of Inswran.::e
Exhibit I'S"; Contract Budget
• TERMS THE SERVICES AND,1(jA MAIERi,l.L'5. FU,",,..,S,HE [) ~mDE.R TH:S Ar:';f1f E~ENT SH": Lt_ c:m'ME"4CE ON _ )J.!J_~ __ L .. ___ L9_~ _______ _
"-'liD SlVl:ll SE (,/'lMPLETEO SEFQPE' ___ ~Jl,J __ 0.L3 O. 1 9 9 ~ ____ m __
• COMPENSA noN Fa;, TP"1E HJLi "'E~FO!'IMANCE OF" ff-llS AGRE£M::'NT
[~CITYSHAL~.f""VCONIPJ.,C,,:"~' Payment'sha!! be made 't'ithin fifteen (15) dOi'fS of rec€.ipt (If
invoice submitted by June 30, 199~. for-2,:!f'"'inistraUve costs~ o CONTAACTORSh/>,LL"A'1CIT" $vbject to City review and audit. Total Pd~'r:.(;!nt shall not exceed
$37,080 for the term specified above.
• PAYMENT RECORD (1)EPAATMENTUSf:AEV~ASE'SIP£;'
• GENERAL TERMS AND CONDITIONS ARE iNCLUDED ON BOTH SiDES or TH~S DOCuMENT.
T~IS AGREe:MEPlT SHA.LL BECOME (fFECTI~ UF'ON ITS A.pp~mAl ANO D'.ECU':"ION BY CiTY. i'-WI:NE~iS THE"'EOF, HiE ::A..":1If.S /-lAVE EKECUTED TH~S
,l,GRHIotHiT THE OAI' MONTH, AND YEAR flFl:ST WP.IITEN :lJjll','t-
,ljOLil HAl!MLfSS. CmrT.'tAcrcR .Qr~ to it.der:'!nifj, d~r~~(f o.fld hQld h i~i~~ c:n, I!S ,1!'f.c~r:; iiQ~·':~ and em;'I~!~c5Ir~m a~~' a"~ JI! cje-'1i1n~., c'airT', 'jf 110 b: I,tj U"
a~'i ~~'J~ 'lxl~1l~f1iO "'rW:~::Jr ~e"'l' r..;u~..!'~ ~l' 0; a·i~in~ out j)~ GQNT"'~C1DA'S <~ '8" ~!'~, ii~~n's (')~ Ull;JIG~e~~' ~~;";~;;i a,:c:;, ~;rJ'1i C· C"1IS~IOn5, or "':::~,J:
~;~~d~~. c, CQrr;'uct 10' ",,'h,,:;r, tr~ 'aw '~;a~~ ~1~':-. r,:;t;;:j"i a~ CONlf\~~.J;; Ir l-'e "'el~i)rman;;~ (); 1.;.1. 'r! 'c, pe 1N"'l1 Ifl S .. :; r!~ -"~. ~ I' (:D~-;-RAC:TQR.
EKTtRE lGfl.HMUn, 1"1$ l~~eG',~"', mltl~ __ \f_'m~_pry'\ CQnr.i"f)"S Cn \~'tWM~I.~ r!il:~S~,: ~~ "(1~',\'. 'i~ ~\::l",tl1~ tlH~,'~e" th'. ):O;".'~S 'toii~, ;es,,~~l lc t:tr~ p,,:ct1as'.
a.1d ;.;].Ie or the ~q:, ipmert, (:"1a I~I 'or5 0' ,LJ;;pJle5 0 r p!ym~nl I,x s~~ ... ces I\'~ Ie h rna, :::.e t:1~ ~~b,I~~ 8' t~l~ co~:"'c: All p r r.' 3 ~ '~,"C:' ~~:s .'~" ru~~ 1;:':, 0,'5, ~:a1~ me -~s
n~~:lcms a'1d u:v.lerW,nli' , .. ''h~:~.~r o~al (II il'mten oIl~ S<J~frsBtfE j ~ "~e~l'
• PROJECT MANAGER "-NDRi::PRE:SH.fIAn'o'r F~ c;!)" "
r'~E Davfd _ F. __ M~ __ r::.t.L0c AdmlnistratCtr __ ~
Human Services
OH'T _~.9.!!!rrLu.QJ..t~..§.I2rY-_if;_~_~; ___ _
P.o, sox 1Cl?50
PAlO AlTO, CA !i4303
T elep~;>€' _3} 9:..2_~_9 ____ _
SOCIAL SfC1Jl'IITY
;:"IF! 11'1 S N'J~IBEP:
• iNVOiCING SE.N::'! A~L IN'IOJCES TO THE CH, "n'. rROJE=GTI,u,r.A::;;E."
• CITV OF PALO ALTO APPROVALS: IROLf'iE-FOA Slm'.Io.TI"RES ACCORlH,c TC'NIJMI'I(RS It>, AF'"HO';'L P.-Oxcs ElFLOW
rTf c)EPAAl'~-iT-D-fi:i~~~~:~~n! Ri~:~~~ ----lri~cE ---------r-;;~~d<S ;. ';ONmCl .... ciM~--S-:<",~i O!.;
\ \') 1',2', ,3: . ,:0"1 I
--------,,------------------->-----------------1 --------------------,,-----------,,--------------------------------------------------------------------------------,
• OVEe" 000 REOU ,eescm "'" "'" "'0"'''' I .... · 0"'"'" ," R',~" RC5 ","" ",OC"" WCoR. Nt: ~'_SIG. ' .. ' ... fU~ ... ' ...•.. S---,...---1 C:'fftlfr>II.lO~~G-------------------~n~Sl ---------;?:P~','fDAST~fJ~~.. j
" --~ _____ C~~_~AA,\G{~ _= __ ~ , S'r ....... ,~., elf'! C::L~"" _________ --~---':-'To,nCll1~~ ___ ~ _____ -1
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PA ro UNIFIED SCHOOL DiSTRICT (P,ilJSIJ)
199)-1994 SCOPE Of SERVICfS
ec-.mi ty Counsel i nLlT.t:lgra.
Sf.VICES: Contractor shall matcn funds 9rante~ ~y t~e City of Palo Alto under
this agr-e-eme.nt to provide two (.Z) full-ti;ne trained coomunity c:ounsi!(ors (one at
Gunn High School and one at Palo Alto Hi9~ School) wto shall address predictable
issues in ado1escence on a requlat. fu1l-time basls at those locations and
increau student access to personal counseling services.
SOAl: To ensure the nai h:bil ity of a couI1selor at each secondary school sHe
whose exclusive responsibility is to address the affective and socio-emot;~nal
needs of secondary students and their famili!s including. but not limited to, the
issues of substance louse, student stress J fami 1y dysfunction, !lid change and
transition.
OBJECTIVES:
1. 8y July I. 1993. ensure School District continued funding cf at least
$37,080 to ~tch City fundin~ for two fUll-tjme Co~un~ty Counselors and
for provision of office space and resources, in order to maximize their
ability to provide for peTs,nal counseling and referral of students.
2. ~rovide direct counsel ;119 ser .... ic-es to' no fewer' than 500 students per
school site during the school year 1993-1994.
3. Ensure that the above reference11 counselors. are actively invo1 .... e-d iii
managin9 a ~;nimum of three (3) human services programs on site whfch are
specifically designed to ~ncrease visibil ity of availabTe services to
students arid maximize individual and group counselir,g services.
4. Coordinate site-based programs 'l\'hich increase personal counsel jng options
for students by empowering various ro1 e groups to aSSL!.'Tle cDunse1 irlg
responsibilities within their oOOln spheres of infTuence or specific
projects which are .counsel ing-b3sed t~ sen"e r.o felilEr than ~OO students
per site during the school year.
S. Facilitate tl1e identification and referr&l of students to appro~riate
outside (ommunity mental health pro¥iders and refer no fewer than twenty
five (25} students per site during the term of this agreement.
REPORTS: Contractor shall provide activity reports relating to this Scope of
Services for the pe:'iods ending November 30. 1993. February 28. 1994, and June
30, 1994. within fifteen days after these dates. Each report shall cover the
preceding period. and othEr sucn information as the Project Manager may request.
The fhlal re~ort shall focus on the final four months, but a1so shall provide
information on cOlltract services for the entire tErm. Each report shall be
prepared in the form agreed upon by the Project Manager ar,d the Contractor.
AIIERICANS lilT!! DISABILITIES ACT: Contractor shall comply .ith the Americans with
Disabilities Act (~.DA) of 1990.
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OHlSlT 'B'
PALO' , IJIIlflID satoo~ D[STl'·'
1 •• _·1994 CONTRACT SUOSET
er:..un i t 't Co!!nse lor Progru
Oesc'";'?t1on
£XDenses
Salaries
TOTAL O:PEIIS£S:
T ota 1 ProJect
Projected Budget
$100,000
$100,000
Contract Budget
&en!iral fund.
S 37,080
$ 31,080
TOfU COHTIW:T BIIlGET: $31,080.00
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ACO~I •.
~t.I::.v.
CA1,lFOF,NI ..... DiSTlTUTtONAl !NS. AGENCY INC.
F' .O~ BO::! lltD28S
SA.."i DIECO, (,&. 92 !6S-2288
SUB AGENT:
ANDREINI AND CQl1PANY
P.O. BOX 59:22
SAN MA'TEO, CALIFCR~IA 9441)2
~:5CJil"'lJ
PAT.O .... LTO UrHfIED SCHOOL DIslRICr
25 CHURCHILL AVENUE
PALO ALTO, C~LIrO~~IA 94305
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THlS Cf}tTljO"ICATE IS ts.slJED AS ~ t.tATTE~ OI"~~~~~~~~:G~! CON.F;;:!=lS Na f\ICKTS UPON T!'IE CeAT~p.C"'!E
COE.S ~OT AM~NO, t:xTENl:' OR Al TE'R THE CO'l:;:RACE
!-,p"Ol.!!Jr.~.]1 ,,,S,-,""<,,,,O"",,-. _________ .. ___________ _
COMPANiES A.rFOflOiNG COVERAGE
I' S1JRANC£ C·:JX?ANY
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